Biliary lithiasis: retrospective analysis of a case series

Area of Science:

• Gastroenterology
• Hepatobiliary Surgery
• Endoscopic Procedures

Background:

• Biliary lithiasis encompasses various conditions, including gallstones (cholelithiasis) and common bile duct stones (cholecystocholedochic calculosis).
• Management strategies for biliary lithiasis have evolved significantly over time, influenced by technological advancements.

Purpose of the Study:

• To analyze the trends in biliary lithiasis management over a decade (1983-1992).
• To evaluate the changing roles of transduodenal and endoscopic papillosphincterotomies in treating biliary tract stones.
• To assess the impact of minimally invasive surgery on endoscopic procedures for biliary calculosis.

Main Methods:

• Retrospective analysis of biliary lithiasis cases treated between 1983 and 1992.
• Comparison of surgical techniques, specifically transduodenal papillosphincterostomy and endoscopic papillosphincterotomy.
• Evaluation of the indications and evolution of endoscopic retrograde cholangiopancreatography (ERCP)-based interventions.

Main Results:

• Cholelithiasis was the most common diagnosis (79.3%), followed by cholecystocholedochic calculosis (16.6%).
• Transduodenal papillosphincterostomies were more frequent in the earlier period, while endoscopic papillosphincterotomy became prevalent later.
• Endoscopic techniques expanded from elective use in specific cases to complementary roles, including managing large stones and pre-laparoscopic cholecystectomy procedures.

Conclusions:

• The study highlights a significant shift in the management of biliary lithiasis, favoring endoscopic interventions over time.
• Technological advancements and the rise of minimally invasive surgery have increasingly integrated endoscopic procedures into biliary tract stone management.
• Endoscopic papillosphincterotomy has become a crucial tool for treating various forms of biliary calculosis, especially in conjunction with modern surgical approaches.